Elevance Health
Miami, FL, USA
Pharmacist Clinical- Prior Authorization (Pharmacist Clinical) Location: Virtual with the ideal candidate living within 50 miles of one of our Elevance Health PulsePoint locations. The Pharmacist Clinical is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs. Primary duties may include, but are not limited to: Researches and synthesizes detailed clinical data related to pharmaceuticals. May review and approve or deny coverage for pharmaceuticals (as permitted by state/federal law or state/federal program contracts) based on medical necessity criteria, and coordinates with internal Elevance Health or health plan medical directors as needed. Serves as a clinical resource to other pharmacists on areas such as dosage conversion and clinical support for therapeutic interventions. Makes prior authorization determinations based upon formulary and evidence- based clinical data. Makes prior authorization determinations, research,...